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ISSN 2007-8560 (Print)
Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2019, Number 2

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Ortho-tips 2019; 15 (2)

Femoral head augmentation in 3-4 part proximal humerus fractures plating in elderly population and it’s failure predictors

López CRE, Krappinger D, Riedl M, Knierzinger D, Wahler W, Kralinge F

Language: English
References: 16
Page: 121-129
PDF size: 166.57 Kb.


ABSTRACT

Bad bone quality and greater age are related to bad outcomes in proximal humerus fractures (PHF). In these patients the use of augmentation helps us to reduce the failure rate. The objective of this study was to evaluate the early complications and mechanical failures in 3 and 4 part PHF treated with femoral head allograft augmentation plating vs plating alone. Methods: We included 30 patients above 65 years old, with 3-4-part PHF treated with Proximal Humeral Internal Locking System (philos) plating (9 augmented patients and 21 non-augmented patients). We evaluated as complication risk factors: deltoid tuberosity index, age, fracture type, calcar extension, varus, head fragment size, the reduction quality and type of fracture and time to surgery. Then we analyze the risk factors for complications, pain and range of motion in both groups. Results: The average age was 78.1 years, 63% of the patients had bad bone quality (DTI Less than 1.44). Of the risk factors we demonstrate that greater age p = 0.03, absence of calcar reconstruction p = 0.05 and absence of augmentation p = 0.05 were 3 statistically significant risk factors for complications. Conclusion: In this study we can conclude that the use of osteosynthesis with plates must be reserved for selected patients on these ages due to the high incidence of complications. We confirm that with greater age the greater the chance for failure. The use of allograft augmentation is a useful tool to use in these cases, but it doesn’t replace the anatomical reduction of the medial calcar.


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